Transfusion-associated adverse reactions (TAARs) and cytokine accumulations in the stored blood components: the impact of prestorage versus poststorage leukoreduction

Chih-Chun Chang; Tai-Chen Lee; Ming-Jang Su; Hsiu-Chen Lin; Fang-Yi Cheng; Yi-Ting Chen; Tzung-Hai Yen; Fang-Yeh Chu

doi:10.18632/oncotarget.23136

Transfusion-associated adverse reactions (TAARs) and cytokine accumulations in the stored blood components: the impact of prestorage versus poststorage leukoreduction

Oncotarget. 2017 Dec 7;9(4):4385-4394. doi: 10.18632/oncotarget.23136. eCollection 2018 Jan 12.

Authors

Chih-Chun Chang^#¹, Tai-Chen Lee^#¹, Ming-Jang Su¹, Hsiu-Chen Lin¹, Fang-Yi Cheng¹, Yi-Ting Chen¹, Tzung-Hai Yen^{2

3}, Fang-Yeh Chu^{1

4

5

6}

Affiliations

¹ Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei, Taiwan.
² Department of Nephrology and Division of Clinical Toxicology and Toxicology Laboratory, Chang Gung Memorial Hospital, Lin-Kou Medical Center, Taoyuan, Taiwan.
³ College of Medicine, Chang Gung University, Taoyuan, Taiwan.
⁴ School of Medical Laboratory Science and Biotechnology, Taipei Medical University, Taipei, Taiwan.
⁵ Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan.
⁶ Department of Medical Laboratory Science and Biotechnology, Yuanpei University, Hsinchu, Taiwan.

^# Contributed equally.

Abstract

Leukoreduction in blood units could prevent patients undergoing transfusions from transfusion-associated adverse reactions (TAARs) such as febrile nonhemolytic transfusion reactions (FNHTRs). However, the effect of prestorage and poststorage leukoreduction on TAARs and its underlying mechanisms in stored blood components remains to be determined. Therefore, we investigated the impact of prestorage leukocyte-reduced (pre-LR) and poststorage leukocyte-reduced (post-LR) blood products, including red blood cells (RBCs) and apheresis platelets (PHs), on the incidence of FNHTRs and other TAARs in patients who received transfusions from 2009 to 2014 in a tertiary care center. We also investigated the difference of leukocyte-related bioactive mediators between pre- and post-LR blood components. The results indicated that prevalence of TAARs was significantly reduced in the transfusions of pre-LR blood components. Particularly, the prevalence of FNHTRs was significantly reduced in the pre-LR RBC transfusions and the prevalence of allergy reactions was markedly reduced in the pre-LR PH transfusions. Furthermore, in vitro evaluation of cytokines in the pre- and post-LR blood components revealed that IL-1β, IL-8 and RANTES levels were significantly elevated in the post-LR RBCs during the storage. In contrast, IL-1β, IL-6 and IL-8 levels were significantly elevated in the post-LR PHs during the storage. These findings suggested that prestorage leukoreduction had a diminishing effect on the development of TAARs, which could be associated with less accumulation of cytokines in the stored blood components.

Keywords: cytokines; febrile nonhemolytic transfusion reactions; poststorage leukoreduction; prestorage leukoreduction; transfusion-associated adverse reactions.